What is Xanthelasmas?
This is a type of xanthoma, which is a medical condition that can cause deposits of fat to develop under any surface of your skin of the body including your feet, hands, elbows, or buttocks and is very common. Having these fatty deposits can often be a sign of having a high amount of cholesterol in your bloodstream. Most of the time xanthelasmas are painless but because they are often noticed they are often an embarrassment to the ones who have them. It is usually yellowish in color and is often found around or on your eyelids. Although you will find them most commonly in people from the Mediterranean region and of Asian origin it can occur in all skin types. Xanthelasmas can be found in both men and women but women are more susceptible to them. They normally occur in people older than fifteen years of age.
There are not any actual symptoms but normally the person who has this medical condition does not feel any type of inflammation, itch, or pain in the affected areas.
- Xanthelasmas looks like a bump or sore under your skin and is usually flat.
- When they are touched the patches will feel partly solid with a slightly change in texture but still have a feeling of softness.
- They are yellow in color.
- These deposits can looked stretched in the edges or have an elliptical shape.
- They either stay their original size or gradually start to commingle or expand.
- They can vary in sizes from very small to larger than three inches.
- As the patches begin to expand the person may not be able to close their eyes properly or because of muscle paralysis or weakness the upper eyelid may start to droop which is called ptosis but either of these two are rare.
There are many things that can cause a person to have a xanthelasmas including:
- An LDL (low density lipoproteins) deficiency LDL is cholesterol that is considered “bad” cholesterol.
- Familial mixed hyperlipidaemia which is a disease where a person has an elevation in their triglyceride, which is the chemical formation of vegetable and animal fats, and cholesterol blood levels who has xanthelasmas. It is an disease that is inherited.
- Having a medical condition that involves an increase in your blood lipids like diabetes, certain cancers, etc
Although it is often associated with high levels of cholesterol all cases are not necessarily associated with elevated lipids or cholesterol.
Many times a diagnosis can be made just my looking at your skin but may have a biopsy done, which will show the fatty deposit. The dermatologist can usually tell by looking at the appearance and color of the patches.
If a person decides to not treat them they will usually not cause any problems. The main reason that a person will have them removed is the location of the xanthelasmas, which is around the eye and they can be unsightly and embarrassing. Because they can be caused by a high cholesterol and triglyceride levels the dermatologist will usually do blood tests to check a person’s blood lipids. Having high levels of cholesterol and triglycerides are bad for a person’s health they will usually recommend you making changes in your lifestyle. These changes means that you should get rid of any excess body weight and reduce your intake of fatty foods. You may also be given prescription medications to help lower your cholesterol levels in your blood.
During the initial stage in some cases they will disappear after a certain time without any medical treatment but it is still advisable to talk to your physician or dermatologist to have the blood tests done to check the levels of cholesterol and triglycerides in your blood. For treatment either your physician or dermatologist can use the simple method of apply liquid nitrogen to stop the xanthelasma from getting bigger but also killing the fatty materials that make up the patch. Once this is done another sample of the fats that were removed will be tested to see if an increase in cholesterol was the reason the xanthelasma occurred.
In addition to using liquid nitrogen the dermatologist can remove it by excision using a sharp instrument, which can also remove the scar that appears after treatment. Other methods the dermatologist can use to remove xanthelasma may include:
- Laser therapy to get rid of the patches but this removal treatment could produce side effects such as a slight change in the pigmentation of the skin in the area that was affected by xanthelasma.
- Electrodesiccation - this removal treatment would have to be done several times to achieve the best result.
- Chemocautery - this is when the dermatologist uses a chemical substance to remove the plaque.
- Cryotherapy - this is the name of the treatment and removal using liquid nitrogen to freeze the plaques.
One of the drawbacks to having xanthelasma removed is they can come back. In order to keep them from coming back a person needs to keep their cholesterol and triglyceride levels under control.